Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13876 | Date 17/12/2025 |
| Token No | SM/25-26/3030 17/12/2025 | Serial | 018 |
| Patient Name | Mrs. PUJA KUMARI SINGH | Contact No | 8271188745 |
| Address | 23 NO N.L.B STREET | Age | 25 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||